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VOLUME 66 , ISSUE 1 ( January-March, 2024 ) > List of Articles


A Case of Tropical Pulmonary Eosinophilia

Bhupendra Jatav, Avani Jain

Keywords : Case report, Diethylcarbamazine, Filarial, Hyper eosinophilic syndrome, Lung disease, Tropical pulmonary eosinophilia

Citation Information : Jatav B, Jain A. A Case of Tropical Pulmonary Eosinophilia. Indian J Chest Dis Allied Sci 2024; 66 (1):23-26.

DOI: 10.5005/jp-journals-11007-0100

License: CC BY-NC 4.0

Published Online: 03-04-2024

Copyright Statement:  Copyright © 2024; The Author(s).


Background: Tropical pulmonary eosinophilia (TPE) is a prominent feature of lymphatic filariasis caused predominantly by lymphatic-dwelling filarial infections (e.g., Wuchereria bancrofti, Brugia malayi, Brugia timori). While some filarial species are endemic in tropical and subtropical regions, worldwide travel and immigration have resulted in incidences in non-endemic areas. Case description: A 26-year-old laboratory worker with a 3-month history of nonproductive cough, dyspnea, and intermittent fever. Initially diagnosed with asthma, but symptoms continued despite medication. Eosinophilia, increased immunoglobulin E (IgE) levels, and reticulonodular lung opacities were discovered in laboratory tests. Spirometry revealed restrictive as well as obstructive behaviors. Clinical criteria validated the diagnosis of TPE, and therapy with diethylcarbamazine (DEC) led to significant symptom alleviation and laboratory improvements. Discussion: Tropical pulmonary eosinophilia is difficult to diagnose due to its diverse appearance, miming illnesses such as asthma and allergic bronchopulmonary aspergillosis. Clinical factors such as residence/travel history, paroxysmal cough, eosinophilia, increased IgE, lung infiltrations, and response to DEC are used to make an accurate diagnosis. Furthermore, differential diagnoses include a variety of eosinophilic lung disorders. Clinicians should be cautious in non-endemic areas and rule out other illnesses caused by helminth infections, such as Loeffler syndrome. Conclusion: This case emphasizes the necessity of including TPE in the differential diagnosis of respiratory symptoms, particularly in non-endemic locations, and indicates the efficacy of DEC in treating this illness.

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  1. Boggild AK, Keystone JS, Kain KC. Tropical pulmonary eosinophilia: A Case series in a setting of nonendemicity. Clin Infect Dis 2004;39(8):1123–1128. DOI: 10.1086/423964.
  2. Mullerpattan JB, Udwadia ZF, Udwadia FE. Tropical pulmonary eosinophilia – A review. Indian J Med Res 2013;138(3):295–302. PMID: 24135173.
  3. World Health Organization. Lymphatic filariasis. World Health Organization. Available from:
  4. Kasper DL, Braunwald E, Hauser S, et al. Harrison's Principles of Internal Medicine. McGraw Hill Professional 2006. Harrison's edition 20th p. 1632 copyright 2018; New York (USA). ISBN: 978-1-25-964404-7.
  5. Jha SK, Karna B, Mahajan K. Tropical Pulmonary Eosinophilia. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2023. Available from:
  6. Ottesen EA, Nutman TB. Tropical pulmonary eosinophilia. Annu Rev Med 1992;43:417–424. DOI: 10.1146/ 002221.
  7. Udwaida FE, Herzog H. Tropical eosinophilia, Pulmonary eosinophilia: Progress in respiration research, Karger: Switzerland 1975(7):35–155.
  8. Rocha A, Dreyer G, Poindexter RW, et al. Syndrome resembling tropical pulmonary eosinophilia but of non-filarial aetiology: Serological findings with filarial antigens. Trans R Soc Trop Med Hyg 1995;89(5):573–575. DOI: 10.1016/0035-9203(95)90112-4.
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